Antismoking efforts by physicians appear to have great potential in getting patients to quit or reduce their smoking. However, despite the fact that most physicians believe it is their responsibility to encourage their patients who smoke to stop, most do not feel well prepared to counsel patients about the quitting process. We propose to extend an ongoing randomized controlled trial of two interventions to increase and improve smoking cessation counseling by physicians by adding an evaluation of the effect of counseling on patient behavior. The two interventions are: (1) a physician tutorial; and (2) an intake/prompting system. Specifically, we are requesting funding for the biochemical verification of patients who report having quit smoking at 12 months following the interventions and for assistance in collecting and analyzing data collected from this 12-month follow-up. We have developed this study in conjunction with the nine Fellows of the University of North Carolina Faculty Development Program who are conducting the ongoing randomized trial. The trial will involve nine sites across North Carolina with 250 resident physicians and approximately 2,000 patients. Currently, the primary outcome of the trial is change in physician counseling behavior. We propose to evaluate more important (but more expensive-to-collect) one-year changes in patient smoking behavior. The importance of reducing cancer morbidity and mortality and its association with smoking cessation, as well as the size and scope of the study, make this a significant research opportunity.